The Arrhythmia Section of the Dr. Balmis General University Hospital has carried out with success for the first time in the province of Alicante two cases of cardiac ganglion plexus ablation, one innovative technique for the treatment of patients with vasovagal syncope or fainting.
Both patients were the first to be included in a national multicenter clinical trialled by the Comprehensive Center for Cardiovascular Diseases HM CIEC Madrid, and in which the Cardiology Service of the Alicante hospital is participating, through the Alicante Health and Biomedical Research Institute (ISABIAL), together with 12 other Spanish hospitals.
The team of professionals of Dr. Balmis’ Arrhythmia Unit, directed by cardiologists Alicia Ibáñez and José Luis Ibáñez, in collaboration with the Anesthesiology service, have performed this procedure supervised by Dr. Jesús Almendral, a cardiologist with extensive experience who is currently the chief of the Cardiac Electrophysiology and Clinical Arrhythmology Unit of the Madrid Hospital Group.
A technique endorsed by different studies
Fainting or vasovagal syncope momentarily generates a fadingin the first case, and the loss of consciousness, in the second, as a consequence of a drop in blood pressure and/or heart rate. “Despite being benign entities, they reduce the quality of life of those who suffer from them and can become disabling if the syncopal episodes are repetitive or if they occur in risky situations, for example, while driving,” says the Head of the Cardiology Service of the Dr. Balmis Hospital, Juan Gabriel Martínez.
At present, “the only treatment available is the placement of pacemaker, which prevents a drop in heart rate, but not a drop in blood pressure, so it does not solve all cases. In addition, pacemakers are indicated for the elderly, since young people require several battery replacements throughout their lives”, he specified.
The novel technique Ganglionic plexus ablation, which has just been performed at the center, is performed by cardiac catheterization. “We access the left atrium using catheters and perform radiofrequency ablation (tissue cancellation) in the ganglion plexuses, which are altered in these patients,” explains cardiologist José Luis Ibáñez. “In effect, by acting on these ganglia their properties are modified and, with this, the decrease in heart rate and blood pressure is avoided.”
This technique has been endorsed by different studies with smaller series of patients as an “effective treatment to eradicate or reduce vasovagal syncope in previously selected patients, which also prevents the placement of a pacemaker,” says cardiologist Alicia Ibáñez.
One of the busiest centers
“Precisely”, adds the doctor, “this clinical trial aims to demonstrate effectiveness of this treatment in a large number of patients, given that it is planned to include more than 92 patients, and it is hoped that, in this way, it can be included in the clinical practice guidelines”.
The participation of the Arrhythmia Section in this work is justified by its wide experience in the atrial fibrillation ablation technique, a treatment for irregular heartbeats that follows a very similar approach. In this sense, it is among the most active centers nationwide, with around 100 procedures per year.
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